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HomeMy WebLinkAboutCOM 0013.182 2002-2004 Kevin Kunz M.D., M.P.H., FASAM 75-137 Hualalai Road Kailua-Kona, Hawaii 96740 808-329-1346 Fax 329-1575 June 17, 2003 Mr. James Arakaki, Council Chair Mr. Aaron Chung Mr. Lenigrad Elarionoff Mr. Joe Reynolds Mr. Gary Safarik Ms. Bobby Jean Leithead Dr. Fred Holschuh Mr. Bob Jacobson Mr. Curtis Tyler Dear Chair and Members, Aloha. I have been a practicing physician in Kona for 22 years. Ten years ago it became apparent that the number one health issue for my patients and their families was the use of both legal and illicit drugs. I subsequently learned that the three most credible medical advisory groups in the Unites States had already determined that addiction to both licit and illicit drugs is the number one medical problem not just our state, but in the country (reports available from U. S. Center for Disease Control and Prevention, The Institute of Medicine, and the Robert Wood Johnson Foundation). As you have surely already learned, the medical condition of drug dependence, or addiction, to tobacco products, as well as alcohol, ice, opiates, and other drugs, kills more people than heart disease or cancer. Ironically, as a culture, we are very uncomfortable with this disease of addiction, and so we have labeled the cause of death as emphysema, coronary artery disease, or cancer instead of tobacco poisoning, or drug overdose. In this deception lies your challenge for today as you amend and vote on Bi11260: please stand up to the stigma and ignorance that feed our communities denial of all of our drug problems, and do not perpetuate the accepted status quo of misery, disability and death which is preventable. Our delicate human biology will respond in predictable ways to drugs without regard to their legal status. If we are to promote the well-being of our residents, their families and neighbors, then our determination to keep our citizens safe from tobacco induced disease must be as strong as our tight against ice and other illicit drugs. Especially, we cannot ~a~ 13 , 182 Ref. Ta EnNMe--ZO 1' Ref. Date'-~'N 1 8 Hawaii County Council dune 17, 2003 Page Two give our youth the double message -some deadly drugs are OK, others are not. The fact is, drug free means tobacco free. You have heard the well-documented scientific and business reasons for supporting this smoking ban. I've attached materials referencing this, but will get to the point. Remember that Hawaii is the "drug state", number one in the nation for ice. And in Hawaii it is well known that Hawaii Island is the ice capital. Let's make the right choice and stand up against all harmful drugs, legal or illegal. Please make bars and restaurants smoke-free. Please do not condone smoking in a childcare business when children are present. [ ask you today to have special vision, courage and concern for your community. Weigh carefully the consequences of passing a diluted bill that will help a few businesses economically. Pass instead a bill that will leave a legacy of hope and health for Hawaii. Please do the right thing, take a stand against drugs. Make Hawaii County the anti-drug capital. Thank you. Sincerely, L" - ` Kevin Kunz, M.D., M.P.H., FASAM Primary Care Physician Board Certified in Preventive Medicine and Public Health Certified in Addiction Medicine by the American Society of Addiction Medicine Kevin Kunz, M.D.,M.P.H., FASAM 75-137 Hualalai Road Kailua-Kona, Hawaii 96740 329-1346 Fax 329-1575 June 16, 2003 Dear Council Members. Aloha. Drug Free Means Tobacco Free There are many reasons to ban tobacco in public places, but I believe that the following are the top ten. For the benefit of our children, lets state clearly: "drug free means tobacco free". 10. Freedom to smoke cannot be freedom to harm. The Freedom-to-Smoke tobacco lobby was conceived and financed by the tobacco industry. Except for tobacco growing states, this argument is now generally accepted as bogus, dishonest, and self- serving. We all share the right to seek health, happiness and freedom. 9. Environmentally sale alternatives exist. Environmentally acceptable forms of tobacco and nicotine are available. For smokers who are addicted, there are many alternative forms of nicotine, which are harmless to others. These include snuff, pinch, chew, nicotine gum, nicotine patches, nicotine inhalers, and nicotine nasal spray. Tobacco in small, clean oral pouches is now available to place by the gums. These products give the needed nicotine fix. The cost is similar to cigarettes. Many nicotine-addicted persons already use these products when flying. Alternative nicotine drug delivery systems do not expose others to the toxic and carcinogenic risk of tobacco smoke. 8. Oahu and Maui are showing us the way. The smoking ban on these istands was passed after public, open debate. The acceptance of a smokeless policy is widespread, and there is no reason to think the Big Island will be unique. 7. Smokers are taxed and treated unfairly. Hawaii has one of the highest tobacco taxes in the country, and it is scheduled to increase. And the Master Tobacco Settlement Fund for Hawaii -$1.38 billion -has minimal contributions to spend on smokers' addiction (only 12.5% over 25 years). It is true -smokers won't be getting their fair share of tobacco tax or settlement money. if we can help them quit by limiting their smoking opportunities, they too will be better off financially. County Council June 16, 2003 Page Two 6. Doomsday economic predictions have not materialized. Jurisdictions that have mandated smoke-free public places have not had the economic downturn that the pro- smoke lobby predicted, and the overall economic advantages have been positive. On the Big Island, the first smoke-free restaurant was Bianelli's, 13 years ago. They didn't lose business, and in fact have tripled their seating! (Yes, I do know that the food is great, the service impeccable and the management akamai. ) 5. Employee and patron health. Nonsmokers who are exposed to cigarette smoke have higher rates of abnormal lung function, respiratory infections, heart disease, and lung cancer than their counterparts who work in tobacco free environments. There is no justification for non-smoking employees or patrons to suffer damage to their health while they are at work, or in a public place. 4. Public pressure helps smokers quit. Despite all of the scientific facts regazding tobacco disease and death, the general knowledge that even smokers have about tobacco's harm, and even though 70% of smokers want to quit when asked, knowledge and desire have proven inadequate in curtailing the American tobacco epidemic. Believe it or not, the most successful element in the campaign to reduce tobacco consumption in the United States has been the "non-smokers rights" movement. By insisting on smoke-free enviroyunents for everyone, tobacco-free advocates are enhancing the chances for better health and longevity for smokers especially. 3. Addiction is a disease. It is a brain disease. Why mess with your brain? Why use a drug that will change your brain, which is where you think and feel, not just when you use it, but for a long time? The hallmarks of addiction aze denial (I smoke because I like the taste, I can quit anytime), lack of control over drug use (...can't stop even for a short time in a restaurant?) continued use despite consequences (50% of smokers with lung cancer keep smoking after surgery!), and the compulsion to use the drug against your will and best intentions. Tobacco is the crack cocaine form of nicotine. People that smoke tobacco become quickly and severely addicted to nicotine. They are not bad people, just addicted. They need help. 2. Successful quit therapies are available. Ninety percent of ex-smokers have quit without any professional help, support groups, or nicotine replacement systems. Most of them tried multiple times before quitting for good. So don't give up. But for the hard-core nicotine addict, many effective therapies are available. In addition to nicotine replacement products like nicotine gum and patches, you can County Council June I6, 2003 Page Three easily receive prescription nicotine products and medications from your doctor. There are also cessation support groups, most of which aze free. Finally, some of that settlement money from Big Tobacco is funding a program on the Big Island to help you quit, and those services are free (call locally 647-QUIT). 1. Drug free means tobacco free. If we want our young people to learn that their lives will be better without addictive drugs, we have to let them know we mean all addictive drugs. We have to be honest. No double messages. Legal drugs are not necessarily less harmful than illicit drugs. In fact, some aze much worse. And especially for our teens, tobacco is the gateway drug. Most experts agree that drug dependence is a childhood disease -almost all people with a drug problem started in adolescence, with tobacco. Our message as a community has to be clear: we oppose the use of a[I dangerous drugs, and that includes all tobacco products. Let's get this tobacco issue settled; we have the ice epidemic to fight. Thank you for attention to these issues. Sincerely, ~ ~ Kevin Kunz, M.D., FASAM r----~,._.~- Coalition for a Tobacco Free Reasons to Make Businesses Smoke-Free Hawaii • Smoke-free policies do not adversely affect business, and sometimes boost it, zos N Knkui sneer, sate zor according to studies that use sales tax data and sound research methods. Honolulu, H! 96817 Tel: (808)432-9JI7 Fax' (808) sz4-9072 • Most smokers accept smoke-free policies and 70% want to quit smoking (National wwietobaccofreehawaii. org Cancer 1nStltute). • Furniture lasts longer and burn holes aze avoided in tablecloths, carpets, or cloth coverings. • Repainting ceilings, walls, and replacing window coverings yellowed by tobacco smoke is eliminated. Smoking in the workplace damages property and increases cleaning costs. A survey of 2,000 workplaces found that 23.3% of those with smoking restrictions reported a reduction in maintenance costs. (Swart, "An Overlooked Cost of Employee Smoking" Personnel, August 1990.) • Ashtrays never have to bought or cleaned again. • Eliminates complaints about drifting smoke. Smoking causes a great deal of discomfort in the workplace. 59.2% of nonsmoking employees report suffering discomfort, and even 15% of smoking employees report some degree of discomfort from secondhand smoke. (CDC, Morbidity and Mortality Weekly Report, May 22, 1992.) • People with asthma, allergies, and other respiratory problems -including seniors - will become more loyal patrons. • Less sick leave caused by exposure to secondhand smoke. • Reduced insurance costs. Many insurance companies will offer lower rates for smoke-free businesses because of healthier employees and reduced fire risk. The National Fire Protection Association found that in 1998 (the most recent year for which data is available) smoking materials caused 8,700 fires in non-residential structures resulting in 17 deaths, 163 injuries, and a direct property damage of $60.5 million. (Hall, Jr., J.R., "The U.S. Smoking-Material Fire Problem," National Fire Protection Association, Fire Analysis and Research Division, April 2001.) • More productive workers. Workers in smoke-free businesses take fewer smoke breaks. Secondhand smoke harms the health and reduces the productivity of nonsmokers, costing employers money. Estimated costs associated with secondhand smoke's effects on nonsmokers range from $56 to $490 per smoker per year. (Kristein, "How Much Can Business Expect to Profit From Smoking Cessation`?" Preventive Medicine, 1983;12:358-381; Jackson & Holle, "Smoking: Perspectives 1985" Primary ('are, 1985; 12:197-216.) March 2003 Coalition for a Tobacco Free Healthier workers. By removing secondhand smoke from the workplace, many iIIawai`l employees' health will improve. Additionally, smokers will smoke fewer cigarettes helping to improve their health. • Reduced liability. As a business owner, if you subject your employees to dangerous situations, you maybe liable if they develop diseases or injuries. By removing smoking, you are not exposing your employees to a hazardous situation. Workers exposed to secondhand smoke on the job are 34% more likely to get lung cancer. (Fontham, et al. Cancer Epidemiology, Biomarkers and Prevention,1991; 135: 35-43.) • Iu 2002, the International Labor Organization (ILO) reported that cancer was the largest killer in the workplace, accounting for approximately 640,000 workplace-related deaths per year globally. ILO stated that secondhand smoke in the workplace is estimated to cause 2.8 percent of al(workplace cancer. (Reuters, May 24, 2002.) • Employees support smoke-free policies. In 2000, the proportion who thought that smoking should not be allowed at all in indoor work areas ranged from 66.4% in Wisconsin to 83.8% in DC. (CDC, "State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke: United States, 2000," Morbidity and Mortality Weekly Report 50(49): 1101-1106, December 14, 2001.) • A survey of businesses conducted by the Building Owners and Management Association (BOMA) International found that the elimination of smoking from a building reduced cleaning expenses by an average of 10%. (Garland, W.S., BOMA Supports Smoking Ban in Buildings, http://www.boma.org/comartle/comsmoke.htm, [n.d.].)